Patient engagement: The new blockbuster

Tel Aviv, 16 October 2013

If patient engagement were

a drug, it would be the

blockbuster drug of the

century and malpractice

not to use it. Leonard Kish

‘ ‘

Page 3

Healthcare’s perfect storm…

Cost containment

initiatives

1.5 billion over-65s

by 2050

€700 billion spent on

chronic disease in EU

Unsustainable growth in health care spending

14% of GDP by 2060, up from 6.2% in the ‘00s

Health care reforms Pricing pressures on

the industry

Changing demographics Unmet needs

Page 4

Customer

Health 1.0 Blockbuster drugs

Health 2.0 Diversified product portfolios

Health 3.0 Information, radical collaborations focused on healthy outcomes

► R&D productivity

► Patent cliff

► Globalization

► Demographics

► Pricing/reimbursement

► Health care reform

► Health IT

► Consumerism

► Value mining

Physician

Patient

Payer

Business models Value proposition

Drivers of change

…is driving new life science business models

Page 5

Social

media

Medtechs HIT Co

Pharmacies

Payers Pharma

Telcos Consumer

electronics Retailers Food Co

Providers

Employers Information

companies

Distributors

How are different health care stakeholders responding to this shift?

Page 6

Health

records

Telecom

Governments

Insurers Retailers

Food

Providers Information companies

Biotech

Academia

Physicians

Social

media CROs

Patients Pharma

Medical

technology

Consumer

electronics

IT

By forming a new health

ecosystem, with the patient

at the centre

Health management

Predisposition testing

Prevention

Diagnosis

Treatment

Page 7

Transforming

care at the

community

level Focus on

holistic care

Educating

patients

Engaging

patients

New approaches

to R&D

Move to

preventive care

Nudging patient

behavior

New growth opportunities

Page 8

Industry leaders are increasingly involving patients in drug development

Patients who are being treated with Roche’s Avastin are

providing samples to help researchers understand how

genetics influences treatment and discover new genetic

markers for cancers.

M2Gen informatics repository currently contains data on more than 400,000 patients, 40,000 tissue samples and 20,000 molecular data files.

Researchers aim to improve treatment

and diagnosis of cancer by analysing

and studying patients’ tumour tissue

samples.

Insights drawn from PatientsLikeMe’s

psoriasis patient community support

research.

Nearly 2000 people share data and

stories on PatientsLikeMe’s

psoriasis patient community.

Innovating cancer research

Advancing personalized medicine

Using community discussions to advance research

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

New approaches to R&D

Page 9

Technology and social media have opened the doors for patients to become active participants in R&D

Mayo Clinic case study: advancement of research on rare diseases through social networking

2003: Patient diagnosed

with Spontaneous

Coronary Artery Dissection

(SCAD)

2005: Started connecting

online with others living

with the rare disease

2009: Convinced Mayo Clinic

cardiologist to initiate a study

around SCAD

2011: Two new SCAD studies

launched

► Built a database of 200 SCAD

patients to help identification of

risk factors

► Developed a bio-bank of DNA

samples to explore genetic

causes of SCAD

2010: Pilot study designed by Mayo

Clinic to recruit participants for a

multi-center SCAD registry

In six months, Mayo Clinic collected

complete medical records and

angiograms from 12 participants

around the world

The study drew interest from

people who heard about it through

the networking site, Facebook,

Mayo Clinic, etc.

Within a week, the study

recruited 18 volunteers

SCAD Support

Group — Internet

social networking

site through

womenheart.org

Internet

The pilot was a success — results of

the study were released in

September 2011

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

New approaches to R&D

Page 10

The patient experience is the sum all interactions, shaped along the cycle of

care, that influence patients and drive desirable behaviors

Changing patient behaviours is difficult

“Listen to me!”

“Don’t patronize

me!”

“Empower me!”

“Educate me!”

“Respect my

culture, values

and beliefs!”

“Help me get

access to care!”

“Help me

manage my

condition!”

“Simplify my

treatment

regiment!”

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

Nudging patient behavior

Page 11

Patient

Understanding the biases in patient behaviour is critical for improving health outcomes

Problem: hot vs. cold states

Solution:

► Technologies to manage

behaviors in hot states

► Social networks for

feedback and reinforcement

► Gamification to create

motivation

► Contracts to lock in

behaviors

Behavioural

change

Problem: big and/or complex

data

Solution: relevant, neutral

information based on individual

circumstances

► Personalized to circumstances

► Made relevant

► Information on choices and

trade-offs

Processing

information

Resisting

temptation

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

Nudging patient behavior

Page 12

Life science companies have already found creative ways to address behavioural issues

Educational material, customized

lifestyle plans and reminders to

help hypertension patients manage

their conditions.

Pfizer uses Keas’ platform to develop

personalized online care plans for

users. Keas’ website motivates

employees with points, badges, and

feedback from co-workers

Novartis’ Get

on Track

program

Pfizer/Keas

31%

50%

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

Nudging patient behavior

Decrease in at-risk patients

Improved adherence vs. not enrolled

Page 13

Focus on prevention can improve cost/benefit outcomes in health systems

Aetna & Health Quality Partners (HQP) care management program

Aetna identified

members using

data analytics

HQP developed risk

profiles and used each

individual’s data to

customize outreach efforts.

HQP nurses provide:

► On-going assessment and monitoring

► Support for on adherence on medication recommended

► Education of patients

► Coaching on self-management

► Close follow-up during transition from hospital to home or nursing

facilities

► Promote physical activity, weight management, healthy eating,

vaccinations, social engagement and home safety

16% reduction in total

hospital-related

expenditures

15% reduction in inpatient

hospital admissions

17% reduction in outpatient

services

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

Shifting towards preventive care

Page 14

Challenge for industry is in developing life-long relationships with patients

Sanofi going beyond drugs to engage patients

Blood glucose

monitors

(iBGStar)

Smartphone

applications

Interactive

websites

WellPoint offering wellness solutions to patients

Fighting obesity by providing convenient virtual services and support - access to online trainer and personalized diet and weight loss plans

Average

weight lost

in FitOrbit

program

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

Educating patients and Engaging patients

Page 15

Business models must be disrupted beyond traditional approaches…

End Stage Renal Disease

Pilot with US Centres for

Medicare & Medicaid

Services (CMS)

demonstrated 12%

reduction in care costs

► Medical care

► Hospital Treatment

► Dialysis

► Drugs

Traditional approach

Managing co-morbidities, nutritional

status, infection risks, access to

vascular care and psychosocial

needs

Integrated care “health home”

Diabetes

► Drugs

► Insulin

► Exercise

► Diet

Traditional approach

Going “beyond the pill” to provide a holistic way of

diabetes treatment, by encouraging lifestyle behavior

changes, providing personalized coaching, sharing real

world data and improving adherence.

Integrated care focused on self management

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

Focusing on holistic care

Page 16

…to transform health care at the community level

Blue Zone: A community-based model that helps people to

live longer, happier, healthier lives

Transforming Cities: Optimising healthcare systems along

the entire value chain

GE collaboration with 10 major employers, 19 hospitals,

500 physicians, 5 insurers and health officials to improve

the health of two million people in Cincinnati.

Iowa’s Blue Zone project aims to make it the healthiest state in

the US by 2016 by driving lifestyle changes. The project could

help the state save around US$16 billion over five years.

California,

Iowa,

Okinawa

Cincinnati,

Louisville,

Houston

Educational and

information

resources

Community health

programs

Foods and food services

Consumer

goods

Real estate

developments

Transforming

care at

community

level Focusing on

holistic care

Educating

patients

Engaging

patients

New

approaches

to R&D

Shifting

towards

preventive care

Nudging

patient

behavior

Transforming care at community level

Page 17

Two disciplines working together for better outcomes

► Research conducted to

understand the intricacies of

diseases

► Clinical research conducted in

different ethnic groups; wide

genetic pool for biomarker testing

► Better success rates of clinical

research

► Early and targeted

market entry

► Research conducted to understand

patients’ biases and behaviour

patterns

► Commercial pilots conducted to

align services

► Customized offerings

► Improved patient outcomes

Science of

medicine

Science of

behavioural

economics

Page 18

Source: Ernst & Young Analysis

Customer-centric; B2C

Health outcomes for patients

Customer Experience

Listening and co-creating

Innovative partnerships

Service and Business Model Development

Reimbursement based on real market effectiveness

Health 3.0 Health outcomes

Product-centric; B2B

Revenue/Margins

Product Efficacy

Pitching

Acquisition of product Companies

Product Development

Approval based on clinical trial data

Health 2.0 Diversified product portfolio

Business Model

Value Drivers

Inorganic Growth

Innovation

Brand Value

Go-to-market strategy

Information

The ideal future business model: From push to patient-centred pull

Page 19

Patient engagement: Points to consider

What is the first step you think you

should take to move forward into

patient engagement?

What are the obstacles to patient

engagement? How do you overcome

them?

What do you see as the benefits to

patient engagement? What does it

look like, to you?

Page 20

Thank you

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